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General NPI Number Information
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NPI Number | 1124886965
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Entity Type | Organization
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Legal Business Name | CENTENNIAL HOUSING & COMMUNITY SERVICES CORPORATION
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Dates
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Enumeration Date | 03/07/2024
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Last Update Date | 03/07/2024
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Provider Practice Location Address
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Address Line | 104 MEDICAL DR
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City | WILLIAMSTON
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State | NC
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Zip | 27892-2156
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Country | US
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Telephone | 217-519-9654
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Fax |
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Provider Business Mailing Address
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Address Line | 958 US HIGHWAY 64 E
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City | PLYMOUTH
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State | NC
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Zip | 27962-9216
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Country | US
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Telephone | 252-795-4135
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | FRANK TITUS AVIGNONE
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Credential |
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Telephone | 214-629-7860
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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